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00:08 Okay, today, we got a of ground to cover, Right?

00:12 gonna start here with homeostasis from we're gonna start talking about the blood

00:17 . Hey, more stasis seems like very, very complex, but it's

00:21 pretty straightforward. All right. They're be four basic steps that you're gonna

00:24 looking at here. And if you know homeostasis, if I don't if

00:28 picture doesn't make it clear, this your way your body's way of making

00:31 band aid. Alright. You're basically you all agree your blood is kind

00:35 important to you? Yeah, You wanna you don't wanna lose your

00:38 So, yeah. So, so band AIDS were existed, your body

00:42 figured out how to make its own aids. And that's what we're

00:44 And we're gonna create blood clots So, there's four basic processes.

00:48 first is gonna be the process of or constriction. All right,

00:53 it's gonna be resulting. What we're do is we're gonna apply pressure and

00:57 we're gonna see the formation of the plug itself, and then we're going

01:00 see the clotting of the blood in area. So, if you pin

01:06 , how many of you guys have gotten trained for cpr and stuff like

01:09 . Okay, So, you guys how to include the flow of

01:13 Right? So, notice how everything just said here matches very much what

01:17 said when you got trained in Cpr and first aid, really? It's

01:21 first day that we're looking at Alright. So, your body is

01:24 that automatically. and and and does simply And so what we're gonna do

01:29 we're gonna kind of just focus on matter if you've if you've cut on

01:32 surface of the skin or if you've internally. The idea here is I've

01:36 a blood vessel some way. That's I've completely cut through it or just

01:41 of shared it. So, I've it a little bit like, what

01:44 seeing here. So, it doesn't which way you're looking at it.

01:46 right. The first thing that's gonna is what is called the vascular

01:51 which is just one of the coolest in physiology. Right. I

01:54 it gives you this image of like , but really? What's going on

01:58 Is that when you when you cut a blood vessel, what it's gonna

02:03 ? And so the way that I'm here is that if you cut it

02:06 half. Alright. So, what's happen is I've cut this blood vessel

02:10 . And so those two open ends gonna allow blood to come through

02:13 What they'll naturally do as a function that damage is they actually squeeze

02:19 So instead of having an open like this, they squeeze on themselves

02:22 this. All right. And what that does is it includes the

02:25 of blood through that vessel. That's what the little picture down here

02:29 the bottom is trying to demonstrate to , is this vascular spasm.

02:34 the smaller the blood vessel, the it is to do the work because

02:37 less pressure in the vessel. And it's able to include and blood doesn't

02:41 pushing through. But you can imagine I get bigger and bigger and bigger

02:45 , it's much much more difficult to the flow of blood, especially in

02:49 artery that has say has a lot pressure driving the blood through it.

02:54 , so that is uh it's advantageous you're talking about small things, blood

02:59 will naturally try to include the flow blood going through them when damage has

03:03 done to that blood vessel. All now this vascular spasm will be promoted

03:10 and over and over again in each step by the materials that are being

03:14 by the platelets and the surrounding Alright, so this is not just

03:18 one time thing, it is being . And then what we're doing is

03:21 reinforcing it again and reinforcing again by actions that are going on along the

03:27 . So, the second thing that's happen, you're gonna see an increase

03:30 tissue pressure and this is just a of a decrease in the trans mural

03:34 . If I have blood pressure. , remember what trans mural pressure is

03:39 difference between the pressures between two points are two points inside and outside.

03:46 not hard. Right. So, kind of tells you it's between the

03:50 . And so what happens if if including the flow of blood or blood

03:54 leaking out? What's happening to the inside the inside the blood vessel?

03:58 going down, Right? And so pressure on the outside, even if

04:01 stays the same with the pressure on inside is going down relatively speaking,

04:05 pressure on the outside is increased. that reinforces that spasm. Alright,

04:10 that's kind of what's going on So there is a there is a

04:14 on the radius and the amount of going on. But the way that

04:17 can think about this second step is really what the body's doing is applying

04:21 to the wound. Right? I this picture. This is actually from

04:26 of those uh um you know the the practice emergencies, you know?

04:33 that's not real blood, that's red . Okay, so those are the

04:37 two steps and so far, that's very similar to what you see in

04:40 aid. Right? I'm going to try to close the clued the flow

04:45 blood, basically stop the flow of pressure to the wound to keep to

04:49 that that flow doesn't take place. , everything else that's going to happen

04:53 is a function of the structure of of the blood vessel and what what

05:00 up the blood vessel and the platelets we described as a very last bit

05:03 class, right? So they're gonna three steps in the formation of the

05:07 plug. They're all A's adhesion activation aggregation. Alright. And so really

05:13 I wanna do is I want to a picture here, and I think

05:15 is a really good picture. platelets naturally don't adhere to the inside

05:21 blood vessels. Alright. In essence cells, the epithelium of the of

05:25 of the blood vessel produces a chemical that says, I don't want you

05:31 around here. Go away. So, the way I like to

05:34 that I think of platelets as teenagers the the uh the thallium as basically

05:39 men like me and they're yelling all time. Stay off my lawn.

05:44 . So, you can automatically see this is naturally going on. Now

05:47 molecule that is is different types of Cyclones. Those process Cyclones are being

05:52 and saying you stay away and the vessels and the And play let's

05:55 okay, sure, fine. what happens is that you get adhesion

06:01 there is something other than a helium in that location. All right.

06:08 we're gonna see this. And just , let's see, do I have

06:10 up here yet? No. So about when when you have a bloody

06:15 or bleeding takes place. Does it long for the blood to to

06:20 No. Right. The reason it and doesn't stay in the liquid is

06:24 it comes across a foreign surface, that it's no longer being told to

06:30 aggregate. All right. So like blood hits the floor, there is

06:36 there's no process. I climbed on floor saying I don't want you to

06:40 , right? When it gets on surface of my skin, there's no

06:44 saying I don't want you to So, the idea here is that

06:47 platelets are responding now to that foreign . In other words, they recognize

06:51 have receptors on their surface that recognize foreign surface. All right now they're

06:58 or being uh in response to sheer . And so in essence, what's

07:03 is that as they slow down there able to come into contact with the

07:08 and because there's no signal that hey, don't congregate here, don't

07:13 here. They do. All So that's where you get the

07:16 All right now, this is a injury. And then we're also going

07:19 see here in just a moment that actual signals. And so the receptors

07:25 what are on those platelets is what's it to recognize where it needs to

07:30 to. So one of the things circulating in the blood is this material

07:35 Von Wilburn Factor. Von Wilburn factor says, hey, hey,

07:39 I need you to start adhering in area. Alright. And that's gonna

07:43 activated through a whole series stuff. really it's other factors like collagen.

07:48 right here you can see here, got a blood vessel popped open

07:52 you can see the collagen and that tissue, or at least that's the

07:56 tissue. So you can imagine there's there, and now we have something

07:59 foreign and that platelet comes into contact that and says, oh, this

08:03 a good place to hang out. like my neighbor's house, right?

08:09 when teenagers started aggregating at a neighbor's , what happens at a party?

08:16 so from the adhesion, the teenagers out, that's where we get

08:22 Alright, what are we gonna We're getting it on our phones,

08:25 gonna get on all social media and gonna call all our friends,

08:29 we know everyone, we think we all our friends who've ever we've made

08:32 with and we're gonna invite them to party, you guys do that,

08:38 ? What a sad generation. That's we did parties of 200 300,

08:44 people, cops showing up people jumping fences. You've seen those movies,

08:52 ? Those are based on real We did. That kind of

08:56 I'm not encouraging it in you. just saying, maybe think about,

09:00 know, getting out a little bit . Alright, so what we're gonna

09:05 is we're gonna see the activation of platelets, and really what they're doing

09:08 is they're releasing those contents of those . So we're releasing the dense Granules

09:12 the alpha Granules and so what we're is factor right. Clotting factor

09:18 which we're gonna learn about the second some fibrinogen. What we're doing is

09:21 releasing materials to promote this activity. releasing signaling molecules to tell them,

09:28 , this is the place to hang . And so what we're gonna do

09:32 we're gonna start changing the way the behave. Not only are we able

09:38 recognize, but we're gonna actually change they're doing in the blood. And

09:42 we're gonna see these morphological changes. of skeletal changes. Now, remember

09:46 is the platelet do you remember? said very briefly when we're leaving

09:50 what was the platelet 40? It's piece of torn off. It's a

09:55 carrier site. This big giant cell basically has these little pieces going

09:59 like so and you're sharing them off in that context of your sharing stuff

10:04 your sharing of acting and my assassin all these little tiny components. So

10:09 within the platelets, you have all mechanisms to change the shape, the

10:12 of skeleton, is there? It's not a real cell. It's just

10:16 bit of a cell. So that's changes that we're gonna be making is

10:19 gonna affect what's already there. So we get that aggregation, everyone's coming

10:24 the party. The signal has been all right. And what we want

10:27 do is we're going to get them aggregate and to jam up and fill

10:32 that space that needs filling up. , so again, this is like

10:36 right. The party we can have 15 people, you know this this

10:39 how all the movies go. You have four friends over. That's

10:42 And you know, you invite four and they invite four friends. They

10:45 four friends and someone then gets on media and you have 400 friends.

10:50 ? So that's what's going on is all showing up here. All

10:54 So, we're gonna see an amplification so these are all gonna be amplified

10:58 a series of those signaling molecules, ? ADP for example, uh from

11:03 alpha two or a two. Excuse , are going to bring them all

11:06 and now they're being activated. So they're doing is they're bridging with each

11:09 . They're attaching to each other and doing those confirmation all changes. And

11:13 they're doing is they're stretching themselves kind of like foam, filling up

11:16 crack right there, changing their And their jamming themselves in there.

11:20 what they're doing is they're sealing the and when doing so they're preventing the

11:26 of the plasma. All right. not just the red blood cells and

11:29 other stuff. It's literally the fluid come through because you basically stacked a

11:33 bunch of sandbags into the hole and can pass through it. All

11:38 And then that act into mice. what they do is they kind of

11:41 on each other and that tightens and and tightens the dam that you've

11:46 So, that's what the aggregation All right? So what is

11:51 The coagulation cascade? All right. gonna have to learn this at some

11:54 in your life. And it's it's of like the most worst thing

11:58 Alright. We're not gonna go through the steps which is good.

12:02 But what I want you to see is we have two basic pathways.

12:05 that's intrinsic, one that's extrinsic. then we have a common pathway.

12:09 all linked to each other. When hear the word intrinsic. What does

12:12 mean? Say again. Inside of . Extrinsic means outside. Alright.

12:20 . And then So, what this us then is that when we're dealing

12:24 this pathway of coagulation intrinsic pathway refers what is available already in the blood

12:32 can cause coagulation. So, we can take a drop of your

12:35 and we can put it on the or on the floor, whatever.

12:38 without anything else, it will naturally . It will it will coagulate,

12:44 ? You do not need to send signal from the tile or from the

12:47 to say coagulate. Because everything that need to cause coagulation already exists.

12:54 right. So, that's one pathway we have what is called the extrinsic

12:58 . The extrinsic pathway says the tissue . That becomes damaged, sends a

13:02 to the blood that says, damage has occurred here. Do something

13:06 do something now. Alright, So what these present and then then then

13:13 have a common pathway shared between So that while the initiation may be

13:18 , the ultimate pathway itself is the what's going to ultimately happen here.

13:25 . In looking at this. I'm gonna go back here. You can

13:27 here there's a whole bunch of roman numerals, right? This is the

13:32 that sucks about the pathway. And this is why we don't spend

13:36 time memorizing anything. First off, roman numerals are the result of the

13:41 in which these molecules were discovered. , you can already see the

13:47 Right. So, it's not like one turns on number two, which

13:51 on number three, which turns on four. You can see here,

13:54 know, 12 is turning on number , which is turning on number

13:59 Right? And if you have those numbers, that means there's some low

14:02 12 and three. That's not being . Right? So, this is

14:06 nightmare thing to kind of remember, you can't just go OK,

14:09 One turns into turns on three. right. So, we're not gonna

14:12 about that at some point. You take a class where you have to

14:17 those things. All right. And apologize for the idiots who named it

14:21 way? Okay, But what I you to understand is the why,

14:27 , why are we doing these two ? And then ultimately let's get down

14:29 the common pathway, and then let's what's going on in the common

14:33 Alright. So, intrinsic everything you is in the blood. The reason

14:37 do this or has this is that Probably a more ancient pathway. It's

14:42 one that's been around for a It takes a little bit of

14:45 So, think about like that scab you picked at, right? Let's

14:49 we had a cut and we get scab right? And what we do

14:51 pick at it and it starts and we're like, 00ops, I

14:54 up the blood vessels. I don't why we always blowing it, but

14:59 do right? Maybe it speeds it . It doesn't right? But what

15:03 doing here is we're going through these steps. So, A. Turns

15:07 B. Turns on C. Turns D. Turns on E. So

15:10 so forth, down this pathway. because you have all these different

15:13 it takes a little bit longer. , So this is initiated by damage

15:19 the vessel wall and it's initiated by platelets, that's the intrinsic pathway,

15:25 ? So, like I said, could put a drop of blood on

15:27 table and you'll naturally get that Alright, The extrinsic pathway, on

15:32 other hand is dependent upon the tissue that's been damaged. Alright, So

15:38 what happens is that tissue goes, ! Something terrible has happened to

15:41 I've been stabbed with a shiv, ? And maybe I actually haven't even

15:46 that blood vessel just yet. But happens, the tissue says, you

15:49 , damage has occurred. I need to include the outflow of blood.

15:54 so what I'm gonna do is I'm you blood start dealing with the issue

15:57 down. So this is a very process, takes about 15 seconds to

16:01 this. Alright, so this is outside of the vessel, inside the

16:07 , outside the vessel. Alright. so what it does is just ignores

16:11 those steps. In essence, it its own signaling molecule to initiate the

16:16 pathway. Whereas here, it's basically bunch of dominoes to initiate the common

16:21 . That's a better way to think it. All right now, once

16:26 initiate this pathway, it will continue until the actual Claude is completed and

16:30 . Alright. And so why we these systems? Well, basically you

16:34 these it's basically a backup system is can kind of think about it like

16:37 way really. The extrinsic is there it means I can get a quick

16:41 like I'm hoping for but I have that's probably been around for a longer

16:44 of time and I'm not gonna get of something that works. I can

16:48 it as a, as a way back up what I'm doing right

16:52 All right, now, everything that turn on, you're gonna want to

16:56 off, right? So for when I have time, I should

17:02 go back here. So for example I'm, when I'm accumulating platelets,

17:08 I want a platelets to keep on till the end of time?

17:12 because that will eventually fill up the vessel equals bad. Right?

17:15 you can imagine the end of helium releasing signals at the same time that

17:21 platelets are releasing signals and saying, , stop aggregating. This is why

17:25 say it's the old man's screaming. the ones calling the cops about the

17:30 , right? The neighbors are being , quit coming onto my yard,

17:35 your beer cups over there, your cups. Really right. And the

17:41 thing is kind of going on here everything that we're gonna turn on.

17:44 something there immediately trying to turn it because we don't want this to go

17:48 of control. You don't want your your blood to go through this process

17:51 just become solidified. You're there to a band aid to solve a short

17:57 problem. Right? And so that's we have all this stuff. All

18:02 . So what I wanna do is want to focus here on the,

18:04 the common pathway and I try to code this so that you can kind

18:07 just follow along even though it doesn't any color over there. Alright,

18:11 the first thing is the formation of pro from an activator here, it's

18:15 growth remains right. And in essence it is, it's the active form

18:19 10. It's the active form of , it's some calcium. And what

18:23 doing is we're bringing in pro thrombin in the plasma membrane or plasma,

18:29 a plasma protein. You know, clotting factors are all plasma proteins that

18:34 exist, they're there and what we're is we're just trying to bring everything

18:38 in its activated form to kickstart everything once you bring all that then plus

18:43 calcium. Then what you're gonna be to do is you're able to create

18:47 enzyme that breaks down pro thrombin, plasma protein and turns it into its

18:52 form, thrombin, that's all it . So what's thrombin thrombin is an

19:00 that takes vibrant region which is another protein and it converts it into

19:07 So what you have is you have inactive form that can't do anything circulating

19:11 blood at all times. And now you've done is you've activated and now

19:14 able to do stuff. So what fiber, well fiber and basically is

19:20 fiber that helps to reinforce and create clot where the platelets have been aggregating

19:26 have been congregating. Aggregating is a word. Right? So you got

19:31 platelets in there going, okay, filling up this space. And now

19:34 I wanna do is I want to that with a whole bunch of fibers

19:37 create a tough material that basically protects environment from the external environment.

19:45 Think about what a scab looks Alright, it's basically all those platelets

19:49 it's basically cross linked with a whole of fibers. Alright, so you

19:53 this mesh and then the factor that that is factor 13. And you

19:57 see here, I'm here's the activated and I'm taking those fibers and creating

20:03 stable form of that. That's all steps. So, basically create an

20:08 . So I can activate one This is now new enzyme that can

20:12 the next protein which are loosely And then what I'm doing is I'm

20:17 stabilize it with another active protein. there's the steps, so thrombin really

20:25 like the key factor in this whole and what I've done that kind of

20:30 out again just so and can they a really good job of highlighting of

20:33 the different places, thrombin is Right? It is an enzyme that

20:38 is its own production. It's an that catalyze is the activation of factor

20:43 into into its active form. It's uh catalyze is the the active or

20:49 inactive form of seven to become the form in the intrinsic pathway.

20:54 It's activating factor 13. So, essence, it's basically turning on everything

21:00 reinforcing this activity. So while you it kind of going on a little

21:04 , the more you get, the and faster the system goes, it's

21:08 positive feedback mechanism, right? So really kind of saying, let's make

21:12 clot as fast as we can, then on top of that it acts

21:16 other things, it acts on those epithelial cells. Remember, get off

21:19 lawn, I got the platelets accumulating , let's keep that going. But

21:23 , by the way, let's make that the platelets are, are forming

21:26 the right place. So let's tell endothelial cells to start releasing more and

21:30 of those inhibitory factors like nitric oxide prostaglandin, basically saying, stop,

21:37 come here, you stay wherever you're . But at the same time,

21:40 me act on the platelets and hey, keep doing what you're

21:43 So you see what we've got here we've got a system that's saying,

21:46 , focus, focus, stay away the areas you're not supposed to

21:50 and I'm just gonna keep pushing the forward. Alright, And what am

21:54 doing in the platelets? I'm activating von Wilburn factor, I'm forced into

21:59 to become released, so on and forth the other thing that does,

22:04 gonna do with this here in a and it tells tissue to help produce

22:09 . This is T. P. . Is tissue plasma an activator and

22:12 on another slide. So, if don't see it in a second,

22:15 mean, you don't need to have right here. All right.

22:20 obviously this is a system that can out of control very quickly.

22:26 And so, for every system that have that can go out of

22:30 Actually, every system we have we something that regulates it. And I

22:33 this was a really good way to of see because it's a very well

22:37 system, but you can see how it is. Alright, so,

22:42 got these peregrine factors, like I , prostaglandin, nitric oxide. What

22:45 doing is you're telling the endothelial cells this stuff so that the platelets aren't

22:50 out of control and and filling out basically limited to the place where they've

22:54 activated in our aggregating. All But then we have some anti coagulant

23:02 means stop the process. All So, we have a tissue factor

23:06 basically prevents the activation of factor Whereas factor 10. Or remember it

23:11 make that common pathway. So, , on blocking here saying stop making

23:15 thrombin. All right. So, have a break on our gas

23:21 We have anti thrombin three. What it do? It's another brake on

23:25 gas pedal, thrombin modeling. Not are we going to press on the

23:29 , but we're gonna actually take out engine that's driving all this stuff so

23:34 bind up thrombin and we move it and destroy it. All right?

23:39 lastly, we have a couple of called protein C. And S.

23:42 what they do is they bind to a modeling and inactivate other factors like

23:48 five and factor seven or sorry, eight. So, for everything that

23:54 turned on, we have something that's , Whoa, slow down. Slow

23:57 , slow down. That's the Now, let's go back to our

24:05 scab. Honestly, let's we're friends , right? Are we friends?

24:12 ? Okay. Got a couple of looking down like I'm not gonna look

24:15 in the eye. All right. be honest here. How many guys

24:19 to play with your scabs? it's fun, isn't it?

24:23 You get that bleeding going, pick, pick, pick,

24:26 look, I gotta go. You like it now picking at it,

24:32 ? Right. And it's really sad it finally goes away, right?

24:35 we go take a shower and part the scab disappears and then you

24:39 you come back and you know, can pick at it for a little

24:41 , but the next time you take shower a little bit more disappears,

24:44 ? It's like man, my it's slowly dissolving, Right? But

24:50 an indicator that this is not a solution, right? The purpose of

24:56 scab is to serve as a temporary while the underlying tissue repairs itself.

25:04 ? So, so it's meant to . And it's picking at It doesn't

25:09 right now? I'm not asking acting your parent is saying stop picking because

25:13 do the same thing. Right? like, oh, I'm gonna just

25:16 at it. Mosquito bites are like I hate them. But they're also

25:22 toy for me, right? Get bleeding. Let that scab comes pick

25:26 it for a little while. All . So, the process of breaking

25:34 that band aid, right? That begins the moment that you begin building

25:40 . Alright, so the process of a clot is called fiber analysis.

25:47 right. So what we're gonna do in the blood. We have this

25:51 there goes finally we have this material plasminogen. Alright, So it's another

25:55 all it is is just another um just so sad how fast is

26:01 It's just another plasma protein. And its job is is to become when

26:07 becomes activated, it's activated by these . Either the one that said the

26:11 or one that's in circulation. And it will do is that it activates

26:16 and plasma serves as a scissor to fiber in. So you created all

26:20 cross links, you made fiber and nice and tight. And it's doing

26:24 job. And now what you have you are going to start breaking it

26:27 the moment that you make it it's that the rate at which it breaks

26:30 . It's fairly slow, relatively Right. So, think about how

26:34 a scab sits around you have it for quite a while, don't

26:38 The bigger the scab, the longer sticks around the purpose of the scab

26:42 the tissue underlying. And so what doing is you don't want it to

26:47 around but you want it to be long enough. So the plan has

26:49 sitting there going clip, clip clip it's working to break that down as

26:56 goes along. Which is why when shower and you start scrubbing at this

27:01 , you're getting rid of the parts you don't need anymore. It's being

27:05 down as it goes along. Now are regulators of the regulators and their

27:10 regulators regulators. And this is just to show you that the rate at

27:13 I make plasma is gonna be regulated other proteins as well. And that's

27:17 I'm trying to show you there. don't think I'm gonna ask you specifically

27:20 names of those proteins and stuff. just mean. Right, I don't

27:27 be too harsh. Alright, so gonna stop there and we'll ask you

27:36 questions. What do we know or do we need to know? What

27:40 I not explain? Well, what you concerned about regarding? Homeostasis does

27:45 up pretty well, does it make ? three heads nodding. four heads

27:52 . All right. Yes, both of you? Mhm.

28:05 Like, I don't understand. It's pressure inside. Right. So,

28:12 , imagine though where the flow of is. If I've included the flow

28:15 blood, then the pressure in that inside that blood vessels a lot

28:19 Right? That's why it's basically you're longer flowing through. So, there's

28:24 pressure where that flow should be. the idea you might have greater pressure

28:29 the back side than you normally but it's not enough to push the

28:33 through relative to the strength of the . That's constricting. So the trans

28:38 pressure is simply that outer pressure reinforcing initial vascular spasm. Okay,

28:51 definitely quiet. I like that. means we understand it. Ready for

28:56 easy, easy stuff. Blood vessels easy. I It's all easy if

29:07 look at it and say it's What have you just done? You've

29:11 it hard. Alright. If it's it's easy and it feels hard and

29:16 say I've got to figure out how it easy? So, it's a

29:20 trick. Now there's stuff that's I mean, organic chemistry, it

29:27 fun compared to this. Oh my . Yeah. We're going to start

29:34 argument. Maybe even a fistfight and not even talking to me being

29:38 I mean, Yeah. Alright. what I wanna do is this is

29:44 that we've kind of already seen. . We talked about a little bit

29:47 this already, right That there is organization to the blood vessels that from

29:52 heart we go from from the heart arteries, from arteries we go down

30:00 arterial. That's good. I mean was going for the big one but

30:04 to capillaries, capillaries to veins and the small ones are venues. So

30:10 artery capillary vein, that's all you to remember right? That's that's the

30:14 in which blood is flowing. We're moving away from the heart and

30:20 back towards the heart. The capillaries the site of exchange and that's really

30:23 this is trying to show you is there are arteries, capillaries and

30:26 Arteries carry blood away from the Capillaries are the site of exchange veins

30:30 where where returning blood back to the . Now obviously we don't have one

30:36 fits all that arteries get smaller and and smaller as they go. Veins

30:41 off really, really small about the of capillary and get bigger and bigger

30:44 bigger as they return back towards the . Alright, so we have names

30:49 those different levels right? The first of artery that you should be familiar

30:55 is the elastic artery. Alright, arteries like your aorta. Alright,

30:59 aorta is not just a little tube comes out of your heart. It

31:02 travels the length of your thoracic cavity your abdomen. Alright. And from

31:08 you get branches off of them. that's where you're gonna start getting named

31:12 named arteries. But this aorta is example of an elastic artery and this

31:18 as a pressure reservoir. Now why I need a pressure reservoir? What

31:23 the two states of the heart Sicilian ? Or if you want to be

31:29 in plain english contraction and relaxation. there's a period of time where I'm

31:35 blood and moving blood forward. And there's a period of time when I'm

31:38 . But do your does your tissue blood all the time? Yeah.

31:44 . It would suck if you don't blood. Right. And so here

31:48 we need to do is we need create an environment that is going to

31:51 for blood to continue while the heart relaxing. So we call this a

31:56 reservoir. Because when blood is ejected the aorta or into an elastic

32:03 it expands. And now you have energy that is going to be used

32:08 into kinetic energy that is going to push the blood back out during the

32:12 of diastolic. Does that make Right. So basically you can think

32:18 why is it elastic and has a bunch of elastic tissue in it?

32:21 when you put pressure inside there that elastic tissue expands that word. And

32:26 when you remove that pressure, it's gonna squeeze on its own and return

32:31 to its original position while pushing the forward. Now the elastic arteries empty

32:37 into what are called the muscular arteries hear what you're doing is you're sending

32:42 blood to the different organs. They're arteries there. The named arteries of

32:46 , like renal artery, would be example of a distributing artery.

32:50 And they get smaller and smaller as go. All right, when we're

32:54 about blood pressure, typically, this what we're talking about is we're talking

32:57 these structures because they're primarily muscular and the ones that are responsible for vessel

33:02 and dilation. They're the ones that all the pressure in the blood vessels

33:08 there. Resistance vessels for the most . And then finally, we get

33:12 to the last little bit. These the arterials and they are also resistance

33:16 , but they're the ones that regulate flow of blood into the capillaries.

33:20 right, So, the itsy bitsy structures the capillaries side of exchange.

33:27 , So, you can think up , when I see artery think transport

33:31 is not going into the interstitial fluid it gets into a capillary fluid from

33:35 interstitial fluid doesn't go into the blood the plasma unless you're in a

33:40 Alright. So, we primarily see where we're going to exchange material between

33:45 blood and the cells, or we're materials from the blood to the external

33:49 , which is the air. the veins is where we're gonna collect

33:54 after exchanges taking place. So we really, really small ones. They

33:57 off small and they get bigger and and bigger. And what we're doing

34:00 we're moving towards the blood vessel or the heart. They don't have the

34:04 degrees of structure. So we just break it down as tiny and

34:08 So vineyards and veins. All right when we get to the big

34:12 the big veins here, what we're do is we're gonna see that they

34:17 fairly easily as a result of the pressure or the outward pressure of the

34:21 . All right. So what happens is as blood enters into them they

34:26 , oh well this is kind of . I'm going to relax. And

34:30 you can actually hold more blood in than a normal vessel because of that

34:34 pressure. And so we think of as blood reservoirs. Yes ma'am.

34:53 the degree of constriction and relaxation or is a function of the sympathetic

35:00 So at any given time your body body is trying to maintain a specific

35:04 of blood pressure. Right? And you're you're we we do not have

35:09 parasympathetic innovation or if there is parasympathetic of the blood vessel it's very very

35:14 . So it's primarily sympathetic. So it's how much sympathetic activity are you

35:19 ? And so really what you're asking question is that that not you're

35:22 But they're asking is am I delivering blood needed to keep the cells alive

35:27 this particular area. And so what gonna do is they're going to do

35:31 degrees of construction, constriction and relaxation upon the needs of the tissue surrounding

35:37 . Does that make sense? so let's let's do an example

35:42 Okay. No, no. So resistance changes as a function of the

35:52 of constriction of relaxation. Right? remember diameter, really? Radius has

35:57 huge impact on on resistance. To the art of the fourth power

36:03 over r to the fourth power is inverse of resistance. So as I

36:09 the radius, I'm really dropping the significantly. But where I constrict then

36:15 increasing the degree of resistance significantly. right, So, do we understand

36:23 concept of blood reservoir? This idea basically this is where blood is always

36:28 be in circulation. It does not moving if it stops moving, bad

36:31 happen. All right. So it slow down to quite a bit,

36:35 it still moves. Alright, when stops moving, then those heavy formed

36:39 kind of drop out and you gotta things. And that's not good.

36:44 when we say blood reservoir, it's a pool of blood sitting around doing

36:47 . It's slow moving blood. It's a bayou, right? If you

36:51 look at the water in the bayou doesn't look like it's moving? But

36:54 moving it's just doing it slower. . Yeah. So where so the

37:08 cava basically. So wherever you have artery typically speaking and none of these

37:13 are all over the show. That's speaking artery and veins run side by

37:16 to it with each other. So wherever the A. R. Is

37:19 , that's where you're gonna see the vena cava as it's being formed is

37:23 up alongside it. Superior vena cava down um from the superior portions above

37:29 above. The heart is responsible for the blood returning back from the head

37:33 region. Right? But they basically right outside the right side, right

37:38 the right atrium. Right? But idea is that whenever you see an

37:42 just think there's a vein right beside and vice versa. All right.

37:46 so we're just we're since we're not the anatomy, we're just presuming these

37:50 things. Now, you'll see this right up here. And this is

37:53 a really good point is that whenever talk about in physiology we kind of

37:57 make it a loop. Right? so the reason we draw it like

38:01 loop is so that you can envision leaving the heart traveling through the systemic

38:05 and returning back, right? But two structures are side by side is

38:11 I want you to envision how it is. All right. So this

38:15 how we envision it as a loop though they are side by side.

38:21 , blood vessels have all the same . It's just when something is

38:26 we just call it. You have of that component, right? And

38:30 , what I want to show you is that the inner layer of all

38:32 blood vessels are filled with an epithelium in to Thalia. Alright. It's

38:38 a special word we use for the for its capital for for the the

38:43 tissue that lines the inner circle or inner inner part of the tube.

38:48 what we can do is we can ask questions about connective tissue and smooth

38:52 . So, we have elastic connective , have fibrous connective tissue and smooth

38:57 . And depending upon which vessel you're at, you're gonna see varying

39:01 So, for example, over here's the aorta, which is an

39:05 artery. It has right there, and lots of elastic fibers. It

39:10 has really fibers, fibers as And that's to ensure that you don't

39:15 expanding the balloon until it pops You want to have something that serves

39:19 a point of resistance. And that's the fibers does. But notice,

39:24 speaking how much smooth muscle it Alright, now, this is a

39:29 large vessel. Right? And when you're talking about a vessel like

39:32 size, What you're looking at is vessel that has a uh lumen.

39:38 about that big. Alright. What talking about, say, a muscular

39:43 a muscular artery. You know, might have a vessel that's like that

39:47 . All right. But if I it the same size relative, you

39:51 , to to that size, you'd that the muscle is much much thicker

39:55 in the elastic one. And that's what this is trying to show

39:57 , is relative concentrations, even though thicknesses are very, very different,

40:04 ? And the sizes are very So, depending on what you're looking

40:08 , you're gonna see varying concentrations of different types of tissues. They all

40:13 enough helium. Right? But look a capillary, Does it have elastic

40:18 tissue? Does it have muscular? it have fibrous? No.

40:23 basically, what is a capillary? a little Itsy bitsy, teeny tiny

40:26 made up of epithelium. Right. about a blood vessel? Well,

40:31 has some elasticity have to if it itself to stretch outward, but it

40:36 have the same amount as, that elastic artery does. Alright,

40:42 , varying concentrations, depending depending upon location and its role in the movement

40:48 blood from one point to the So, if we remember those rules

40:51 we learned at the beginning, elastic artery, muscular artery arterials?

40:55 can kind of see where do I to see these things. I don't

40:59 to see a lot of elasticity in smaller arteries. I expect to see

41:02 muscle, right? When I'm over in the vineyards. What do I

41:07 ? I expect to see muscle and so much elasticity, but I do

41:13 them not to pop. So arteries functions move the blood from the heart

41:24 the tissues. Secondly, we're talking big arteries pressure reservoirs, that's just

41:32 keep the blood always flowing when we down to the small enough structures.

41:37 have your arterials, but you can see some of the muscular arteries kind

41:40 fall in this line when I get to the small vessels. Now,

41:43 dealing with resistance and that has to with radius. All right,

41:49 What we're gonna see and you've seen chart before where you saw the systolic

41:53 diastolic systolic diastolic got smaller and smaller smaller until ultimately what's gonna happen is

41:58 resistance becomes great enough. So, can't see the differences between systolic and

42:03 . In other words, it prevents pulse, it'll um appearance of that

42:09 gradient and instead, what you end as you end up with a smooth

42:14 . Now, each of the arterials be adjusted independently of each other.

42:21 right, I'll we're gonna we'll see in just a second when we look

42:29 blood flow during exercise. Alright, they're gonna do is they're going to

42:36 what the heart is pumping out to tissues that need it. Alright,

42:41 , we're not gonna saturate every tissue the time with all more blood than

42:46 needs. We're gonna send blood to it needs to go is a way

42:50 kind of think about this. And , you're constantly constricting and relaxing blood

42:55 to ensure that blood is going where needs to go. Now, what

42:59 end up happening is you'll end up into a region like what we're looking

43:02 . So, here, you can your little tiny arterial, you can

43:04 the smooth muscle that plays that role creating that resistance and then what this

43:08 . It represents a capillary bed and the opposite side, is that

43:13 All right. So, you can arterial blood goes in the capillaries and

43:16 it goes via the venue. but entering into the capillary bed is

43:20 structure that's referred to as a meta . It's not an artery and it's

43:25 a capillary, it sits in Alright, at the openings of these

43:30 arterials, you're gonna see a capillary , right? Really at the point

43:36 where the capillaries are, blood flows in. And so these sphincters serve

43:40 determine where the blood is actually going go. Now, just to give

43:45 you a sense of how many blood you have and how many miles and

43:49 and miles of blood vessels you have that there is not a cell in

43:52 body that is more than 10 microns from a blood vessel from a source

43:58 of of the auction or or or know, glucose or whatever it needs

44:04 blood. All right. So, got a lot of blood vessels is

44:08 I'm trying to get at. But any given time you're not feeding every

44:12 solitary capillary, all that blood you're distributing where the blood needs to

44:18 So, it's these capillary sphincters that see going into these capillaries that determines

44:24 the blood is going to actually Now, just to be clear these

44:29 vessel constriction and dilation referred to narrowing enlarging the blood vessels. Just so

44:35 you can picture constrict, make smaller , make bigger. Alright, every

44:40 vessel you have already has a certain of tone to it, meaning that

44:44 not completely open and it's not completely . It's it's someplace in the

44:49 They're regulated through the sympathetic system. , if I increase sympathetic activity,

44:55 gonna cause constriction. Right? And I'm gonna get vessel constriction. If

45:01 decrease sympathetic activity, that's going to in dilation. So, what I'm

45:07 is I'm basically saying, okay, to its natural tone. Which direction

45:11 I want to go? All So this is what is regulating that

45:22 . Now, what this picture is to show you is where I am

45:26 rest versus what I am when I'm or what you are doing, maybe

45:31 what I'm doing. Maybe what you're . Okay. So, when I

45:35 to exercise, my heart beats right? And it beats harder.

45:42 the amount of blood that's circulating through body is actually going up.

45:47 So we we see that for in given minute if I increase my heart

45:52 , what happens to my cardiac it goes up. If I beat

45:56 , what happens to my stroke Cardiac output goes up. Alright,

46:00 that's why we looked at that formula there at the very front end of

46:04 the stuff that we're talking about. right, So where does that blood

46:09 from? I mean, I've got finite amount of blood. Well,

46:12 where the blood reservoirs become important. right now again, remember blood vessels

46:17 right next to each other, but kind of separating them out.

46:20 I'm just gonna say, pretend this your artery side and pretend this is

46:24 your venue all side of venus Right? So during normal activity,

46:30 got more blood hanging out on the side than I have on the artery

46:36 . Right? Why? Well, the veins can relax and so when

46:41 veins relaxed, they basically hold more , blood still moves towards the heart

46:45 it but it just moves slower through heart and because of frank starling the

46:49 pumps, just what whatever you give . And so I'm pushing out and

46:52 80 mils and then that 80 mils over here and it's like slows

46:57 it's not gonna come rushing out like does when I'm squeezing it out of

47:01 ventricles, it slows down. But blood because I've expanded outward, that

47:06 still returns back to the blood. just arriving slower. Does that make

47:11 ? It's like a river and a a river has water flowing through

47:16 But it's a thin channel. So in a river moves fast.

47:21 But then I come out to a , the bayou is wide. It

47:26 receives the same amount of blood, the blood. Let's hope not.

47:32 It receives the same amount of But the water moving through the bayou

47:36 , even though it's the same volume was coming in is moving slower.

47:42 ? Same volume. Different speed. . Yeah. Also it's all based

47:53 . So the large ones are. , so again, where does that

47:57 does that dividing line between small and ? It's there someplace. All

48:03 But I'm not gonna say that was large one and that one, even

48:06 it's a micron smaller, smaller. I don't want to play that

48:09 All right. But what you what I want you to think about

48:11 that it's just it basically it it kind of relaxes when it gets more

48:17 . All right, So when I , what is the autonomic response sympathetic

48:24 parasympathetic, sympathetic? Right? So activity doesn't make my heart do beats

48:32 and faster. And how does sympathetic blood vessels typically constricts them.

48:40 we're going to learn something new. little bit of nuance in that in

48:42 a second here. But I want to just generally speaking. Makes my

48:46 get tight. So, you're saying resistance. So blood moves faster through

48:51 . All right. And then on venus side, I also get vezo

48:56 . So, what am I I'm squeezing the blood vessel so,

49:00 not able to hold as much So, what is it doing I'm

49:05 started with the P ended with Pre load. I'm pushing more blood

49:10 to the heart frank. Starling no problem. I'll just push it

49:13 on the front end. And that's you get that going through.

49:16 now we have more blood circulating through I'm no longer holding blood over on

49:21 venus side. I'm circulating it faster the system. Alright, alright,

49:26 , where's it gonna go? the other aspect of our bodies is

49:31 we have what are called conditioning A conditioning organ is an organ

49:36 under normal restful conditions, receives more than it ever needs. All

49:42 In other words, it serves as place to say, yeah, just

49:45 it there. All right, Because we need it, we know where

49:48 can get it. All right. so, that's what these conditioning I

49:52 . Reconditioning organs are all right. so, you can see up here

49:56 they're trying to show you a couple these, like, the kidney kidneys

49:59 reconditioning organ, Alright, I can our blood to the kidney. It's

50:03 big deal. I'm just filtering stuff of the blood. Not a

50:06 If I need to. If I that blood, I know where to

50:09 it. I can send it away the kidney and send it to where

50:12 needs to go. Um, skeletal , obviously, not a reconditioning

50:17 right? I want to give the muscle as much blood as it needs

50:21 order to perform its function. Skin one. It's not a reconditioning.

50:27 , just, kind of, trying decide, uh, show you here

50:30 that blood is actually going. when I begin exercising, look what

50:35 , OO, there's abdominal, There gets 1300, the amount of

50:39 going into those reconditioning organs drops But I'm not losing blood, because

50:46 my kidneys need to work hard while exercising? No. All they're doing

50:51 just going through going, Yeah, don't need that. You don't need

50:53 . You don't You do need You don't need that. So,

50:55 rate at which it's working is stays or less constant. But when I'm

51:01 from a bear, do my skeletal need more blood. So, imagine

51:06 we're giving every organ all the blood needed. You know, I

51:11 you know, this flat thing. , if I needed to run away

51:13 a bear, there's no place to more blood, no oxygen, no

51:18 . Your now lunch. Right? that's where you're gonna see these increases

51:24 those where the activity is needed. so this is a function of modifying

51:30 amount of blood being held in the , Alright? And that is

51:37 I squeeze the tube. Now the thing that you need to kind of

51:44 is that when blood is leaving the , what we're dealing with is a

51:48 of blood per per unit time. ? And so if I am constricting

51:55 , let's say I constrict one I don't want blood to go to

51:57 kidney. Then what that also means that I have to compensate for that

52:03 amount of blood. Right? here would be an example of

52:06 I'm sending to the kidney and to to the digestive system, over the

52:10 muscle, over to the brain, ? So if I'm sending a leader

52:15 minute to all those different structures, that means my total flow over here

52:20 match what's leaving the heart, But if I constrict to one of

52:26 structures, that means the other ones to make up for it because I'm

52:30 changing how much blood is leaving the . So when we talk about regulating

52:38 structures, this is what we're talking is like, oh, it's not

52:41 be this. Well, everyone, open up. It's I'm gonna open

52:46 here, I'm gonna close up there I'm actually shunting where blood actually needs

52:50 go. So each individual arterial is upon its specific resistance, which I

52:58 regulate independent of the other ones. this is gonna be more or less

53:02 on the needs of the system that trying to provide perfusion to When you

53:13 capillaries. There are three basic types capillaries. Easy one. This one

53:17 easy, is the continuous one. is one you're familiar with when you

53:22 of a capillary. This is what think about. All right. So

53:25 taking your hands putting them together, into a bucket with a bunch of

53:29 with water. And you take your in there and you scoop marbles and

53:33 pull it out. Water is gonna between the fingers in your hands.

53:39 , marble stay. So this is a capillary works is basically a bunch

53:45 leaky tight junctions. So materials can of escape in between the cells.

53:49 the big things are too big to so they stay inside the blood

53:53 And so the reason these capillaries can as a point of exchange is because

53:57 can allow things to escape back and between these two is the most common

54:02 . They're all over the place. right in some places we're gonna see

54:08 are called finished rated. And what we've done is we're modifying that

54:13 model. All right, we're gonna it leaky here. And so

54:17 what we've done trying to find my is what we're doing is we're putting

54:24 uh administrations. In other words, creating gaps in the cells. Were

54:29 vesicles where two vesicles come together and form a complete channel inside the

54:35 And that's what the administration's do. so this is where you're gonna want

54:38 move more materials in and out of of the blood vessel. Alright,

54:43 the kidneys are an example where this where you're going to see these and

54:47 you'll see things like the sinus And these are really weird. This

54:51 basically we don't have any connective tissue it. So there's nothing serving as

54:55 of as a screen or great. cells themselves look like cheese or swiss

55:00 . So, they got big, gaping holes. The cells themselves can

55:03 be separated from each other. So don't even have like they're not tight

55:07 this or loose like this. you can have lots of big

55:10 The liver in the spleen is where gonna see a lot of this and

55:13 spleen in particular, um is a where we're gonna recycle red blood

55:18 And so what you wanna do is want to send them through these capillaries

55:21 basically kind of tear the red blood apart and then kind of create this

55:25 area. So all that stuff can of flush out. So you see

55:29 quite often in there. So they're very very leaky. So you can

55:33 of normal leaky, really leaky. are very very specific where they're

55:39 These are very specific. These are . And so what we're doing is

55:43 allowing exchange to take place. When talking about exchange, we're talking about

55:48 things your body wants things your body to get rid of right between the

55:53 and the blood. How do I these things around? So, capillaries

55:56 the side of exchange. All Um and what we're doing is we

56:01 very very thin walls are very very . We've kind of showed you that

56:04 when we looked at the red blood about those rulers being formed lots and

56:08 of branching. All right. And I mentioned about 10 microns apart between

56:12 cell and it's a source of of . And I love this graph right

56:17 from your textbook because it shows you relative cross section in terms of area

56:22 your blood vessels in these different Right? So you can see what

56:26 cross section your blood vessels. When you get down to the

56:32 the amount of area that you see incredibly high. All right.

56:38 let's put this into perspective for a . All right. Remember when I

56:42 describing a river there's a small channel which fluid flows quickly through.

56:49 So that would be like what you over there where it says four

56:51 that would be like your aorta. order is pretty big, right?

56:55 you only got one right? And you keep dividing and dividing and dividing

57:00 dividing eventually you get down a whole of little tiny. Itsy bitsy tiny

57:03 like this. But there are so capillaries that if you do the cross

57:08 now you have this massive um area can accommodate that volume. So the

57:15 through the capillaries does what goes way , right? If I'm going faster

57:23 aorta, which is big but doesn't a lot of surface area, a

57:27 of area inside. If I got lot of itsy bitsy tiny areas,

57:30 they sum up to a greater area the original, then the flow

57:35 that has to be very slow. this is advantageous. Why do I

57:40 to have things going slow in a More time for exchange. Right?

57:47 about you driving through a drive through going through at 60 mph. You

57:51 you're gonna get what you need? , I mean, maybe the top

57:55 at Taco Bell might be able to it through your window as you're going

57:58 odds are pretty good. That's not happen, right? But if you

58:02 slow down have that conversation with that person. Alright. You know,

58:07 on, we're gonna flirt with the who you know, it's like

58:10 you're gonna get more sauce. So things slow down and that's what

58:17 shows you. It shows you the of flow between these two different

58:20 Now I want to be clear we're talking about velocity versus quantity,

58:27 ? So when we've been talking about , we've been talking about quantity leaders

58:31 per millimeter, right, velocities speed help you visualize this, pick yourself

58:37 the highway, right? You're going miles an hour and you have a

58:42 of cars around you, right? say there's four cars around you and

58:45 going 60 miles an hour. You're about velocity, right, quantity is

58:49 four. Right? But you can or you can keep the quantity the

58:54 and you can all slow down, ? Like think about the 59-88

58:59 right? You know what I'm talking ? It's like everyone gets down to

59:03 mph all trying to get in front each other. Right? The other

59:07 you can look at it, This you sit on the side of the

59:09 , you count the number of cars by in a minute, right?

59:12 would be volume or velocity volume. right. But now you're using a

59:18 and you're trying to see how fast going. That's velocity. Okay,

59:23 those two things are very different, ? One is how fast millimeters per

59:29 versus how many per millimeter. Alright . So we've been focusing here at

59:37 rate. That's that F. In formula F. Equals delta P.

59:41 our so that blood flow through the depending upon the amount of resistance in

59:50 arterial is greater. The resistance the , the less blood is gonna find

59:55 into the capillaries. This is all controlled. Alright. Number of open

60:01 . If I have an area that's need of material oxygen and glucose.

60:06 I'm going to open up those Blood flows into those areas and then

60:11 that area with oxygen and glucose. I've got all the oxygen glucose I

60:16 . Well let me close up those and let me send the oxygen glucose

60:19 another area. Think about it like . If your hand was a series

60:23 capillary beds. Alright. Each of represents a capillary bed. I'm gonna

60:27 oxygen glucose to this area for a while the other ones don't get

60:31 And then once I've saturated I'm just close that Kapler and go to the

60:34 one and saturate that one. And I'm gonna saturate this one, then

60:37 gonna saturate that and I'm just rotating the blood is actually going at any

60:42 time to ensure that everyone is getting they need and how do I know

60:46 they need? Well the cells are tell me right, they play an

60:50 role in communicating to the surrounding epithelium they need their nutrients when their oxygen

60:58 . So local factors play a major based on metabolic need, sympathetic

61:04 Does that as well? Right, activity increases in response to metabolic

61:12 That kind of makes sense. So about when you're running right, you're

61:17 . What color do you turn write? Why? Well, you're

61:23 heating up and you need to remove heat. And so what's happening is

61:26 opening up all your capillaries to get blood up to the surface. That's

61:30 sympathetic response. And what you're trying do is you're trying to shut off

61:34 . But similarly that heat is also of metabolic activity. Remember our cells

61:40 not particularly efficient of using their So as they burn through their

61:44 they produce heat. So that is indicator of metabolic activity. So that's

61:48 open up the capillaries as well. gonna draw an oxygen glucose.

61:54 so the cells themselves tell the blood um oxygen glucose, please. I'm

62:03 show you this except in a second further. How we doing on

62:08 All right, we're cruising, We're catch up. I like this.

62:11 right. So the vineyards, they go from capital to the vineyard.

62:16 basically we saw that picture right, is your venue. You're basically exiting

62:21 that way. So there's a lot communication going on between the two

62:25 So if this is saying, I'm sending blood into this capillary

62:29 the venus side basically dilates to say go ahead. And it creates that

62:34 gradient so that blood flows through back the venue. Als right? So

62:38 two sides are talking to each so you're you're making sure that you

62:42 enough pressure difference. So blood flows the right direction is what I'm trying

62:45 get out. And when you get the veins now you have very little

62:48 to flow, right? You're not . And what's happening is that the

62:54 vessel itself actually relaxes as it fills . So because it has um no

63:00 or less elasticity um basically what it is when blood comes in and

63:05 oh alright, I'm feeling I'm feeling pressure inside here. So when I

63:09 that pressure, I'm just gonna relax little bit more like bad pantyhose,

63:14 ? You ever had bad pantyhose put foot and they just, they never

63:18 back, they just keep relaxing All right, I'm gonna talk to

63:21 guys guys that pair of underwear, haven't thrown away, that band,

63:26 , that pair of socks that you on and it just stays super stretched

63:30 now, you know what I'm talking ? See you throw all your old

63:34 away, don't you? Okay? a result blood is going to spend

63:39 time in the veins. Why I greater volume, more space, more

63:44 can sit in there and go hey like it in here and as a

63:47 of there being more space blood flows . Just like what we said,

63:52 like a bayou, it's wide. can accommodate and slow things down.

63:57 that's what's going on. Now. know I showed you the picture that's

64:06 around, right, showed you arteries to capillaries and then we're coming back

64:10 again. All right. But it's not your feet, it's

64:14 You have arteries and veins and capillaries all these different structures, right?

64:19 have near the heart. You have far away from the heart. But

64:23 we Wanna do is we want to that blood vessels overcome the effect of

64:28 . Gravity has an effect on on fluids. It's gonna pull it

64:33 And so all our veins have these way valves and they're about 2-4 cm

64:38 . So like about this far And so what that does is it

64:41 up that column of blood from the down to the lowest structures in your

64:46 . And so this ensures that as accumulates in the blood vessels that it's

64:51 popping down and keeps going down and and down. Instead, it's just

64:54 small volume of blood and that doesn't a lot of mass. And so

64:58 easy to propel forward through a couple those different mechanisms that we've described but

65:04 can fail. And so this is they're trying to show you and this

65:06 what a varicose vein is. It's the valve fails. And so instead

65:10 having a valve and a valve or the other one I guess right

65:15 Right. A valve and a what happens is is now if that

65:19 fails instead of having something that's like big now you have something that that's

65:22 and a valve that's only capable of a smaller volume. This valve is

65:28 going to fail and what ends up is you get um you get blood

65:34 inappropriately in these areas which causes an expansion that remains expanded. And so

65:41 what that varicose vein is all So you get this swelling and enlargement

65:45 I've tried to find the ugliest pictures could just so that you can see

65:48 things to look forward to. Um this typically occurs primarily in the superficial

65:55 . It's not gonna slow blood getting to the heart. I mean I

65:59 maybe if all of your veins did would be bad but for the most

66:02 they're mostly just cosmetically ugly. Yeah far as I know. No I

66:10 not and that's been asked me before I've looked maybe they can now I

66:15 usually what they do like with spider which is a similar thing. It's

66:20 at the surfaces are opened up really tiny uh really really microscopic veins

66:27 they'll go fill them up with silicone that you basically included. So,

66:31 blood has to find a different but for something like this, you

66:35 repair that as far as I So, Yeah. Yeah.

66:47 So, capillaries are about exchange. for some math. I like

66:56 All right. Alright. Exchange occurs through Transito sis. All right.

67:05 we're gonna do? We're gonna move from the blood vessels between the cells

67:09 back out again. Alright. There certain things that are too big for

67:13 . So, what we're gonna do we're gonna use um carry mated carrier

67:17 exocet psychosis. So, that form Transito sis All right, So,

67:22 would be trans cellular. Alright, , Transito sis between the cells.

67:26 cellular is through the cell. Um Did I get that right?

67:34 no, I got him flipped translated the cells. Trans psychosis is through

67:39 cell. Okay. Sorry. So you are, the easier it is

67:45 get between the cells. So lipid primarily. Um Yeah, gasses will

67:57 through easily. Um You can create small pores, which is what I

68:02 talking about. They already exist because helium is is so small that you

68:08 get to vesicles side by side, actually create a narrow passage. And

68:13 with regard to the thinnest rated those where they are. You have more

68:16 them and they're so they're more But everything you learned about diffusion is

68:22 here? Okay, so just think all the things, all the rules

68:25 you learned about diffusion and the effects they that diffusion has on the movement

68:29 materials. Now when we're talking about nutrients to the cells, you'll often

68:39 materials moving from the blood to the . But remember we have interstitial

68:43 So really what we're talking about is moving from the plasma into the interstitial

68:48 and from the interstitial fluid to the and vice versa. So it's not

68:53 , it's indirect. Alright. And to move those materials, what we're

68:58 do is we're gonna follow some basic that we've already learned. We can

69:02 at individual salutes and ask the what is the the flow? What

69:07 how is this diffusing is what is concentration gradients through which these materials are

69:12 be flowing? Or we're gonna ask big question. Which direction are things

69:15 generally speaking for all the things. so that is the individual. So

69:20 would be a concentration gradient, you're moving down your concentration gradients. So

69:24 my concentration is high there and low , I'm moving into the cells vice

69:28 . If I have lots inside the . A little over here, I'm

69:31 move out of the cells through the fluid and into the plasma. When

69:36 talking about bulk flow? I'm talking ? How are things moving? Generally

69:42 . So what is the fluid and does it contain? In which direction

69:45 it going? So on the arterial , am I moving from the blood

69:50 the cells are moving from the cells the blood. They go caterpillar on

69:54 arterial side of the capillary. Which do you think? I'm going from

70:00 blood to the cells and then from venue inside my materials are moving generally

70:04 , from cells to the blood. right. So you can see we

70:09 this general bulk flow. Does that mean that that that's gonna be 100%

70:13 . No. For each individual. you you can look at each

70:16 But as a general thing you can of as blood comes in through the

70:21 into the capillary material is gonna flow the plasma into the interstitial fluid as

70:28 unit. And then as I go the venue all side I'm gonna move

70:33 a unit, primarily from the interstitial back into that capillary. Now to

70:41 which is flowing in which direction. need to understand what are the driving

70:45 ? What are the pressures that are and therefore pressures? Right to our

70:51 , to our colloidal osmotic pressures. , so hydrostatic pressure is what type

70:57 pressure? It's the fluid, writes fluids pressure. What is the colorado

71:03 pressure? What's what causes that All right. And so we just

71:08 to think we have two compartments inside capillary. Outside the capillary.

71:12 you can think interstitial fluid and capillary . So, I have one that's

71:17 for the capillary one. That's colloidal for the capillary for the interstitial

71:22 Similar one hydrostatic pressure. One interstitial pressure. Or uh colored osmotic

71:30 Alright, so, what I'm gonna ? I'm gonna break this down for

71:33 . All right? So inside the , right, the hydrostatic pressure is

71:38 the pressure of the fluid of the inside and so on the arterial

71:41 you can go into measure and it's 35 millimeters of mercury. All

71:45 And then on the ventral side because the resistance inside that blood vessel.

71:49 pressure is about 15 millimeters of So, you can see the difference

71:52 . Right. I mean, you kind of see yeah, blood is

71:55 flow from the arterial side of the inside, Right? Because that difference

72:00 pressure in terms of the colloidal osmotic . The amount of plasma protein that

72:06 inside the capillary is going to be or less constant. So we can

72:11 and measure out that and it comes to about roughly 25 mm of

72:15 Alright, so this is the pressure draws fluid regardless if I'm on the

72:19 side or on the ventral side into capillary. This pressure out here is

72:26 driving fluid out of the capillary. ? Because this is relative to atmospheric

72:33 here. The interstitial fluid also has hydrostatic pressure. Remember we're talking about

72:38 mural this is the other half of trans mural pressure. This is one

72:41 . This is the other half. it's asking the question, what is

72:44 ? Well, if I go and it out, it's about negative

72:49 Right? It's very low. It's we just call it zero for our

72:52 . It makes our lives easy. ? So relative to atmospheric pressure it's

72:56 nothing. And you can really kind visualize it if I take a needle

73:00 poke you and um don't actually hit blood vessel. Is water gonna leak

73:06 of your body? Are you a character? I remember when you like

73:11 all the bullet holes in the water out. That doesn't happen to

73:13 right? Because the pressure inside your is roughly the same pressure as the

73:18 of your body. So the hydrostatic doesn't really exist differently than the atmospheric

73:24 . And then finally, if you at the colloidal osmotic pressure in the

73:27 fluid. Do you have any plasma there? What do you think are

73:33 plasma proteins in the interstitial fluid? , if they were what would we

73:37 them interstitial fluid parties. That's where name plaza protocol. It's in the

73:44 . And so if you look at , you'd see that there are none

73:48 . And so if there are then you have no colloids. Osmotic

73:53 . So it's roughly equal to So we have four pressures. Two

73:56 them are close to zero. If zero. And then we have two

74:02 actually have a value that we can . And all we gotta do now

74:05 just ask the question, what do pressures do? Right? This pushes

74:12 out or fluid out. This pulse in this push pushes fluid into the

74:18 . This pulls fluid back out of capillary. And all we gotta do

74:21 is just do a little bit of and everyone loves math. I'm gonna

74:28 it easy for you. I'm gonna you the formula that the book talks

74:31 . But I'm gonna show you another right? There is another way to

74:34 it. All right. And basically says, what is the pressure out

74:38 what's the pressure in? And so can just plug those things in,

74:43 ? one minus the other and then the pressure out versus the pressure

74:48 Which is that right there. And can give you the form that will

74:51 you whether the pressure is driving things pulling things out. Now, when

74:56 learned this stuff, this is the that I learned is to put all

74:59 pressures out versus all the pressures So, it's just the same

75:03 I'm just moving the characters and and doing some rearrangement. What's that's the

75:10 community property. Do you remember that ? Way back in 6th grade when

75:14 learned those definitions, I can't remember one it is distributive. I think

75:18 distributed property. All right. But essence, you can do the same

75:22 . And what happens is if you the math and throw those numbers in

75:25 we showed you the 35 and the and 15 and the zero and the

75:29 and put them in the places. you find is if the pressure is

75:32 positive number, then what that's telling that that particular location, then the

75:37 flow is gonna be filtration or the flow. Its outward flow. So

75:41 filtration. If that number comes, negative after you throw that, then

75:45 says the flow is not outward. it's towards the capillary, inward.

75:50 so, what you have is that kinda makes sense. I'm just

75:54 flip to this slide. So you kind of see it. So over

75:57 is where I have that 35 right here is where I'd have that

76:03 And then we remember what we're doing we're dealing with that 25 ka

76:06 So 35 minus 25 is what? . So that would be a positive

76:11 . What's 15 minus 25 negative Yeah. And so you can see

76:17 , I've got a positive 10 versus negative 10. So on this

76:20 what I see is I see that fluid is being pushed out of the

76:24 into the interstitial space And then there's point of transition. And then now

76:28 I'm doing is I'm pulling fluid back the capillary and so you can see

76:33 flowing out and then I'm flowing back and then then off to the vineyards

76:38 go and it's this movement, this flow that allows me to have exchange

76:42 place. So on the artery I'm carrying oxygen glucose and I'm delivering

76:47 to the cells. I'm also carrying dioxide and other waste. But for

76:51 most part oxygen glucose. And then get all those things exchange and

76:55 And now I've got a lot of dioxide and a lot of waste product

76:58 now the blood naturally flows back out the capillary or into the capillaries and

77:03 out through the venue als So, where exchange occurs. That kinda makes

77:11 . I'm looking at her eyebrows, eyebrows are doing this, see it's

77:16 frustration. Look, I'm gonna try see where I'm at. All

77:22 So, I'm gonna answer it. gonna try to explain and I'm gonna

77:25 this last slide and then we'll be . We'll deal with lymphatic and the

77:28 stuff before we do respiration and I respiration it's really easy. All

77:38 So, what we're saying here is we compare and look at those

77:43 you know, along the line. we're going to see is that the

77:48 nearest the artery because of the collide . The differences between them because of

77:54 differences in the hydrostatic pressures. We're to see a positive pressure that pushes

77:59 out of the blood and into that space. And as that blood is

78:04 then the pressure is going to be . Would you agree with that?

78:08 if I remove something then there's So that means there's less pressure and

78:12 over the length of the capillary as move towards the venus side is I'm

78:17 less and less and less pressure until a point when the pressure on the

78:23 of the capillary is less than the on the outside in the interstitial

78:28 And at that point now the flow fluid reverses itself. It's no longer

78:34 to escape the capillary is now being back into the capillary and it's bringing

78:38 it those materials that need to be from that area. And so that

78:44 is gonna become bigger and bigger and partly because the blood in the veins

78:48 the venus side in the venue is away. And if there's no pressure

78:52 the vein then the fluid from or there's no blood inside the vein then

78:57 going to be replaced by the blood the cap player which creates kind of

79:00 negative pressure. And so that's why drawing blood faster and faster away.

79:08 I'm gonna point this out here first then deal with that next slide.

79:12 then we'll come back under any under normal circumstances, the amount of

79:18 that's filtered filters the stuff that's leaving capillary. There's more filtered than that's

79:24 . That said in english means more is leaving the capital than is

79:29 More plasma is leaving the capital than returning. So we need to have

79:33 mechanism to fix that problem. And what the lymphatic system is about.

79:38 plays a role in the immune but it plays an important role in

79:41 blood back and this is kind of the circulation looks like. So we

79:46 three loops. We have the cardiac . That's that first look loop,

79:50 ? So basically what we're doing is pumping about five liters per minute.

79:53 as you're sitting here for the last and 20 minutes is you can just

79:57 that number. That's what, 80 , multiplied by five. That's how

80:03 blood you pumped In this 11 class day. That's about 7200 L per

80:10 . Your heart is a very active . Then we have the trans vascular

80:14 , that's what's being pumped across the . Alright, so here, what

80:18 doing is that's about 20 liters that been filtered. In other words,

80:21 can go out and go into the space and then what comes back in

80:25 the reabsorbed, you get about 18. So if you're five liters

80:29 blood over the course of of a , Well really not of a day

80:36 you're basically losing two L of two liters of fluid. Now of

80:42 , you imagine your blood is getting and thicker and thicker. So what

80:45 gotta do is you gotta fix that . And so that's what this third

80:48 , the lymphatic loop. The thing gonna talk about first thing on Tuesday

80:52 is it says wait a second um that two leaders need to go back

80:57 here. So what we're gonna do we're gonna catch that and we're gonna

81:00 it back and so that's what we're to deal with lymphatic system. Did

81:08 help you on that last

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